OBJECTIVE To investigate whether poor antidepressant tolerability is associated with functional brain changes in children and adolescents of parents with bipolar I disorder (at-risk youth). METHODS Seventy-three at-risk youth (ages 9-20 years old) who participated in a prospective study and had an available baseline functional magnetic resonance imaging (fMRI) scan were included. Research records were reviewed for the incidence of adverse reactions related to antidepressant exposure during follow-up. The sample was divided among at-risk youth without antidepressant exposure (n=21), at-risk youth with antidepressant exposure and no adverse reaction (n=12), at-risk youth with antidepressant-related adverse reaction (n=21), and healthy controls (n=20). The fMRI task was a continuous performance test with emotional distracters. Region-of-interest mean activation in brain areas of the fronto-limbic emotional circuit was compared among groups. RESULTS Right amygdala activation in response to emotional distracters significantly differed among groups (F3,66 = 3.1, p = 0.03). At-risk youth with an antidepressant-related adverse reaction had the lowest amygdala activation, while at-risk youth without antidepressant exposure had the highest activation (p = 0.004). CONCLUSIONS Decreased right amygdala activation in response to emotional distracters is associated with experiencing an antidepressant-related adverse reaction in at-risk youth. Further studies to determine whether amygdala activation is a useful biomarker for antidepressant-related adverse events are needed.

中文翻译：

---

有双相情感障碍风险的青少年抗抑郁治疗耐受性差与大脑功能激活之间的关联

目的 调查抗抑郁药耐受性差是否与双相 I 型障碍（高危青少年）父母的儿童和青少年的大脑功能变化有关。方法 73 名高危青年（年龄 9-20 岁）参与了一项前瞻性研究，并进行了可用的基线功能磁共振成像 (fMRI) 扫描。回顾研究记录，了解随访期间与抗抑郁药暴露相关的不良反应发生率。样本分为未接触抗抑郁药的高危青少年 (n=21)、接触抗抑郁药且无不良反应的高危青少年 (n=12)、有抗抑郁药相关不良反应的高危青少年 (n=21) , 和健康对照 (n=20)。fMRI 任务是一项带有情绪干扰因素的连续性能测试。在各组之间比较了额叶边缘情绪回路大脑区域的感兴趣区域平均激活。结果 响应情绪干扰因素的右侧杏仁核激活在各组之间存在显着差异（F3,66 = 3.1，p = 0.03）。有抗抑郁药相关不良反应的高危青少年杏仁核激活最低，而未接触抗抑郁药的高危青少年激活最高（p = 0.004）。结论 对情绪干扰物的右侧杏仁核激活减少与高危青少年经历抗抑郁药相关的不良反应有关。需要进一步研究以确定杏仁核激活是否是抗抑郁药相关不良事件的有用生物标志物。结果 响应情绪干扰因素的右侧杏仁核激活在各组之间存在显着差异（F3,66 = 3.1，p = 0.03）。有抗抑郁药相关不良反应的高危青少年杏仁核激活最低，而未接触抗抑郁药的高危青少年激活最高（p = 0.004）。结论 对情绪干扰物的右侧杏仁核激活减少与高危青少年经历抗抑郁药相关的不良反应有关。需要进一步研究以确定杏仁核激活是否是抗抑郁药相关不良事件的有用生物标志物。结果 响应情绪干扰因素的右侧杏仁核激活在各组之间存在显着差异（F3,66 = 3.1，p = 0.03）。有抗抑郁药相关不良反应的高危青少年杏仁核激活最低，而未接触抗抑郁药的高危青少年激活最高（p = 0.004）。结论 对情绪干扰物的右侧杏仁核激活减少与高危青少年经历抗抑郁药相关的不良反应有关。需要进一步研究以确定杏仁核激活是否是抗抑郁药相关不良事件的有用生物标志物。而没有接触抗抑郁药的高危青年的激活程度最高（p = 0.004）。结论 对情绪干扰物的右侧杏仁核激活减少与高危青少年经历抗抑郁药相关的不良反应有关。需要进一步研究以确定杏仁核激活是否是抗抑郁药相关不良事件的有用生物标志物。而没有接触抗抑郁药的高危青年的激活程度最高（p = 0.004）。结论 对情绪干扰物的右侧杏仁核激活减少与高危青少年经历抗抑郁药相关的不良反应有关。需要进一步研究以确定杏仁核激活是否是抗抑郁药相关不良事件的有用生物标志物。